Three-dimensional Location Approach with Silk Thread Guided Laparoscopic Segmentectomy for Liver Tumor

Area of Science:

• Hepatobiliary Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Accurate resection margins and adequate residual liver parenchyma are critical in hepatectomy for liver tumors.
• Current methods like intraoperative ultrasound and indocyanine green fluorescence navigation have technical limitations.
• Precise surgical planning is essential for complex liver resections.

Purpose of the Study:

• To introduce and evaluate the 3D-Liver Analysis and Surgical Tracking (3D-LAST) technique for precise liver tumor resection.
• To demonstrate the applicability of 3D-LAST in laparoscopic liver segmentectomy.
• To assess the safety, efficacy, and practicality of 3D-LAST for intraoperative liver navigation.

Main Methods:

• Development of the 3D-LAST technique using computer post-processing of computed tomography (CT) scans to create 3D volumetric images.
• Preoperative 3D positioning to identify anatomical landmarks and calculate resection ranges for single liver tumors.
• Intraoperative marking of resection margins using silk thread based on 3D software calculations.

Main Results:

• The 3D-LAST technique provides intuitive and stereoscopic visualization of complex internal liver anatomy.
• Preoperative 3D planning and intraoperative marking enabled accurate determination of the optimal cutting plane.
• The study demonstrated the viability of 3D-LAST in laparoscopic segmentectomy for liver tumors.

Conclusions:

• 3D-LAST is a safe, effective, and practical new method for intraoperative liver navigation.
• The technique offers a time-saving and accurate approach to determining resection planes.
• 3D-LAST shows significant potential for widespread adoption in liver surgery.